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Uijen MJM, Lassche G, van Engen-van Grunsven ACH, Driessen CML, van Herpen CML. Case series of docetaxel, trastuzumab, and pertuzumab (DTP) as first line anti-HER2 therapy and ado-trastuzumab emtansine (T-DM1) as second line for recurrent or metastatic HER2-positive salivary duct carcinoma. Oral Oncol 2022; 125:105703. [PMID: 34995931 DOI: 10.1016/j.oraloncology.2021.105703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Salivary duct carcinoma (SDC) overexpresses Human Epidermal growth factor Receptor 2 (HER2) in 29-46% of cases, favoring anti-HER2 therapy. Here, we present the results of patients with recurrent or metastatic HER2-positive SDC treated with docetaxel, trastuzumab, and pertuzumab (DTP) as first line anti-HER2 therapy and subsequently ado-trastuzumab emtansine (T-DM1) in second line. Furthermore, we searched for potential biomarkers. METHODS Retrospective case series from a tertiary hospital. First line anti-HER2 treatment consisted of DTP, after progression T-DM1 was considered for patients with an adequate performance status. Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were assessed and related to mRNA-based PI3K and MAPK signaling pathway activity scores. RESULTS Thirteen SDC HER2 + patients received DTP. In twelve evaluable patients, one complete response (CR) and six partial responses (PR) were observed (ORR 58%), with a median PFS of 6.9 months (95%-CI 5.3-8.5). Seven patients received subsequent T-DM1 in second line, resulting in four PR (ORR 57%), with a median PFS of 4.4 months (95%-CI 0-18.8). Median OS after start of DTP was 42.0 months (95%-CI 13.8-70.1). Grade ≥ 3 toxicity on DTP was seen in 39% of patients, and 14% on T-DM1. Highest combined PI3K and MAPK signaling was seen in the patient with CR and lowest in the patient with progressive disease on DTP. CONCLUSION In R/M HER2-positive SDC patients DTP followed by T-DM1 upon progression are promising treatments, leading to responses in the majority (58%) of the patients at an acceptable toxicity profile.
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Affiliation(s)
- M J M Uijen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - G Lassche
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - A C H van Engen-van Grunsven
- Department of Pathology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - C M L Driessen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands.
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Lugtenberg RT, Boers-Doets CB, Witteveen PO, van Herpen CML, Wymenga ANM, de Groot JWB, Hoeben A, Del Grande C, van Doorn B, Koldenhof JJ, Driessen CML, Gelderblom H. Prospective practice survey of management of cetuximab-related skin reactions. Support Care Cancer 2020; 29:3497-3506. [PMID: 33150521 PMCID: PMC8163687 DOI: 10.1007/s00520-020-05862-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/26/2020] [Indexed: 01/09/2023]
Abstract
Purpose Evidence-based guidelines on how to prevent or treat cetuximab-related skin reactions are lacking and multiple care and management strategies are used. The main purpose of the present study is to gain information about the different skincare products being used against skin reactions in metastatic colorectal cancer (mCRC) and recurrent/metastatic (R/M) or locally advanced (LA) squamous cell cancer of the head and neck (SCCHN) patients treated with cetuximab. Methods An open-label, prospective observational study conducted in the Netherlands. The occurrence of skin reactions and the care and management options taken were documented for 16 weeks, starting from the first administration of cetuximab. Results A total of 103 patients were included in 7 hospitals. 38 patients (37%) developed a grade ≥ 2 skin reaction. Eighty-six patients could be analysed for the primary endpoint (73.3% males, mean age 62.4 years, n = 44 LA SCCHN, n = 16 R/M SCCHN, n = 26 mCRC). The most frequently used skin products at some point during the observation period were moisturizing products (70%), systemic antibiotics (64%), topical antibiotics (58%), lipid-regenerating (28%) and other topical products (28%). The overall use of products gradually increased from baseline to week 6–10, reducing by week 16. Hospital protocols were the primary reason (> 50%) for choice of the skincare products and medications. Conclusion A variety of skin care products and antibiotics were commonly used. Only few patients developed severe cutaneous reactions. For patients, the occurrence of skin reactions did not influence their willingness to continue cetuximab therapy.
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Affiliation(s)
- R T Lugtenberg
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - C B Boers-Doets
- Department of Medical Strategy, CancerMed, Wormer, The Netherlands.,Department of Adverse Event Research & Valorisation, Impaqtt Foundation, Wormer, The Netherlands
| | - P O Witteveen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - A N M Wymenga
- Department of Medical Oncolog, Medical Spectrum Twente, Enschede, The Netherlands
| | - J W B de Groot
- Department of Medical Oncology, Isala Oncology Center, Zwolle, The Netherlands
| | - A Hoeben
- Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center+, Maastricht, The Netherlands
| | - C Del Grande
- Merck B.V., Netherlands, an affiliate of Merck KgaA, Darmstadt Germany, Schiphol-Rijk, The Netherlands
| | - B van Doorn
- Merck B.V., Netherlands, an affiliate of Merck KgaA, Darmstadt Germany, Schiphol-Rijk, The Netherlands
| | - J J Koldenhof
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C M L Driessen
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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Uijen MJM, Lassche G, van Engen-van Grunsven ACH, Tada Y, Verhaegh GW, Schalken JA, Driessen CML, van Herpen CML. Systemic therapy in the management of recurrent or metastatic salivary duct carcinoma: A systematic review. Cancer Treat Rev 2020; 89:102069. [PMID: 32717621 DOI: 10.1016/j.ctrv.2020.102069] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is an aggressive subtype of salivary gland cancer. Approximately half of SDC patients will develop recurrences or metastases. Therapeutic palliative therapy is therefore often needed. The majority of SDC tumors expresses the androgen receptor (AR) and one-third expresses human epidermal growth factor receptor 2 (HER2), both are potential therapeutic targets. The aim of this paper is to systematically review and summarize the evidence on systemic palliative therapy for SDC and to provide treatment recommendations. MATERIALS AND METHODS Electronic libraries were systematically searched with a broad search strategy to identify studies where SDC patients received systemic therapy. Due to the rarity of SDC no restrictions were placed on study designs. RESULTS The search resulted in 2014 articles of which 153 were full-text analyzed. Forty-five studies were included in the analysis, which included in total 256 SDC patients receiving systemic therapy. Two phase 2 trials primarily including SDC patients were identified. The majority of the studies were case series or case reports, resulting in an overall low quality of available evidence. Based on studies including ≥ 5 SDC patients, objective responses to HER2 targeting agents were observed in 60-70%, to AR pathway agents in 18-53% and to chemotherapy in 10-50%. CONCLUSION For AR or HER2 positive SDC, agents targeting these pathways are the cornerstone for palliative treatment. Regarding chemotherapy, the combination of carboplatin combined with a taxane is best studied. Regarding other targeted agents and immunotherapy evidence is anecdotal, limiting formulation of treatment recommendations for these antineoplastic agents.
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Affiliation(s)
- M J M Uijen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - G Lassche
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A C H van Engen-van Grunsven
- Department of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Y Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - G W Verhaegh
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J A Schalken
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C M L Driessen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
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Ham JC, Tops BBJ, Driessen CML, van Raaij AWM, Slootweg PJ, Melchers WJG, Ligtenberg MJL, van Herpen CML. Using a semi-conductor sequencing-based panel for genotyping of HPV-positive and HPV-negative oropharyngeal cancer: a retrospective pilot study. Clin Otolaryngol 2017; 42:681-686. [PMID: 27882657 DOI: 10.1111/coa.12800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to assess the feasibility of testing actionable mutations in small amounts of formalin-fixed paraffin-embedded material in multiple genes of the receptor tyrosine kinase pathway and to determine the frequency of these mutations in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal cancer (OPC). DESIGN A retrospective pilot study was performed. SETTING In OPC, no predictive markers for response to epidermal growth factor receptor inhibition are known. Therefore, identifying predictive biomarkers is of utmost importance, but is often hampered by the small amount of tumour material available. PARTICIPANTS We included the archival material of 45 OPC, all treated with concomitant chemoradiotherapy between 2003 and 2010. MAIN OUTCOME MEASURES Besides the HPV status, we assessed mutations using a gene panel that targets 16 genes in the receptor tyrosine kinase pathway and six other genes. The polymerase chain reaction required only 10 ng DNA. RESULTS In total, 42 of the 45 biopsies have been successfully analysed. In total 20 of 42 samples were HPV-positive and 22 of 42 were HPV-negative. In the receptor tyrosine kinase pathway, mutations in PIK3CA were most frequently identified. A TP53 mutation was identified in one HPV-positive sample and in 13 HPV-negative samples. Additionally, three mutations in three different genes were found. CONCLUSIONS We evaluated an assay to identify mutations in the receptor tyrosine kinase pathway. As only small amounts of formalin-fixed paraffin-embedded material are sufficient for reliable analysis, this test opens up new possibilities for personalised medicine.
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Affiliation(s)
- J C Ham
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B B J Tops
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C M L Driessen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A W M van Raaij
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - W J G Melchers
- Department of Medical Microbiology and Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M J L Ligtenberg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
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Driessen CML, de Boer JP, Gelderblom H, Rasch CRN, de Jong MA, Verbist BM, Melchers WJG, Tesselaar MET, van der Graaf WTA, Kaanders JHAM, van Herpen CML. Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil followed by randomization to two cisplatin-based concomitant chemoradiotherapy schedules in patients with locally advanced head and neck cancer (CONDOR study) (Dutch Head and Neck Society 08-01): A randomized phase II study. Eur J Cancer 2015; 52:77-84. [PMID: 26655558 DOI: 10.1016/j.ejca.2015.09.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/24/2015] [Accepted: 09/24/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To study the feasibility of induction chemotherapy added to concomitant cisplatin-based chemoradiotherapy (CRT) in patients with locally advanced head and neck cancer (LAHNC). PATIENTS AND METHODS LAHNC patients were treated with 4 courses of docetaxel/cisplatin/5-fluorouracil (TPF) followed by randomization to either cisplatin 100 mg/m(2) with conventional radiotherapy (cis100 + RT) or cisplatin 40 mg/m(2) weekly with accelerated radiotherapy (cis40 + ART). Primary endpoint was feasibility, defined as receiving ≥ 90% of the scheduled total radiation dose. Based on power analysis 70 patients were needed. RESULTS 65 patients were enrolled. The data safety monitoring board advised to prematurely terminate the study, because only 22% and 41% (32% in total) of the patients treated with cis100 + RT (n = 27) and cis40 + ART (n = 29) could receive the planned dose cisplatin during CRT, respectively, even though the primary endpoint was reached. Most common grade 3-4 toxicity was febrile neutropenia (18%) during TPF and dehydration (26% vs 14%), dysphagia (26% vs 24%) and mucositis (22% vs 57%) during cis100 + RT and cis40 + ART, respectively. For the patients treated with cis100 + RT and cis40 + ART, two years progression free survival and overall survival were 70% and 78% versus 72% and 79%, respectively. CONCLUSION After TPF induction chemotherapy, cisplatin-containing CRT is not feasible in LAHNC patients, because the total planned cisplatin dose could only be administered in 32% of the patients due to toxicity. However, all but 2 patients received more than 90% of the planned radiotherapy. Clinical Trials Information: NCT00774319.
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Affiliation(s)
- C M L Driessen
- Departments of Medical Oncology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands.
| | - J P de Boer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - H Gelderblom
- Departments of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - C R N Rasch
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - M A de Jong
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - B M Verbist
- Department of Radiology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands; Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - W J G Melchers
- Department of Medical Microbiology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands
| | - M E T Tesselaar
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - W T A van der Graaf
- Departments of Medical Oncology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands; The institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK
| | - J H A M Kaanders
- Department of Radiation Oncology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands
| | - C M L van Herpen
- Departments of Medical Oncology, Radboud University Medical Center Nijmegen, PO Box 9191, 6500 HB, Nijmegen, The Netherlands
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Driessen CML, van Rossum MM, Blokx WAM, van Herpen CML. Skin lesions in a patient with head and neck cancer. Neth J Med 2013; 71:481-485. [PMID: 24218424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- C M L Driessen
- Department of Medical Oncology, Radboud university medical center, Nijmegen, the Netherlands
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Driessen CML, de Kleine-Bolt KME, Vingerhoets AJJM, Mols F, Vreugdenhil G. Assessing the impact of chemotherapy-induced peripheral neurotoxicity on the quality of life of cancer patients: the introduction of a new measure. Support Care Cancer 2011; 20:877-81. [PMID: 22160655 PMCID: PMC3297756 DOI: 10.1007/s00520-011-1336-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 11/28/2011] [Indexed: 11/30/2022]
Abstract
Purpose To investigate the impact of chemotherapy-induced neurotoxicity on daily activities and quality of life (QoL) of cancer patients. Methods QoL of all patients visiting the oncological outpatient ward of the Maxima Medical Centre in the Netherlands from October 2006 until March 2007 treated with taxanes, vinca-alkaloids and/or platinum compounds (n = 88) was compared with the QoL of patients that did not receive these treatments yet (n = 43). Patient-reported neuropathy symptoms were evaluated with the newly developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group/Neurotoxicity (FACT/GOG-Ntx) questionnaire. Results Patients treated with chemotherapy reported significantly more complaints of neuropathy (p < 0.001) and more paresthesias and dysesthesias in the upper (p < 0.001; p < 0.01) and lower extremities (p < 0.001) compared to those not treated with chemotherapy. They additionally experienced problems with fine motor function (e.g., getting (un)dressed, writing, and picking up small objects). Moreover, cold-induced paresthesias were frequently reported. Overall, patients indicated that their neuropathy had a negative effect on QoL. Conclusions The newly developed CINQ and the FACT/GOG-Ntx results suggest a considerable negative impact of patient-reported neuropathy symptoms on daily activities and QoL in cancer patients treated with chemotherapy. However, further validation of the CINQ is needed.
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Affiliation(s)
- C M L Driessen
- Department of Internal Medicine, Maxima Medical Centre, Veldhoven, The Netherlands
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